Colorectal cancer prevention: choosing the most effective population strategy using bio-mathematical approaches.

Abstract

Colorectal cancer is a leading cause of cancer-related death globally, though in theory at least, it is eminently preventable in many cases. Preventive strategies are either primary or secondary, but for population strategists, choosing the 'best' approach is not straightforward. Here, we summarize the potential role of bio-mathematical modelling, specifically focusing on a model that combines known details of crypt cell kinetics with stochastic models of cell birth and death processes. Examples are discussed of the potential population effects of an agent that modulates cell kinetics, such as aspirin, vs one that merely reduces mutational rates.